Maternal morbidity following caesarean delivery: A prospective observational study from a tertiary care centre

Caesarean section (CS) remains one of the most commonly performed obstetric surgical procedures worldwide, with a steadily rising incidence across tertiary care settings. Despite its life-saving role in managing high-risk pregnancies, CS is associated with significant intraoperative and postoperative maternal morbidity, particularly in low- and middle-income countries where patient-related and procedural risk factors often coexist. This prospective observational study aimed to evaluate the incidence, pattern, and determinants of maternal complications following caesarean section in a tertiary care hospital. A total of 3,218 women who underwent CS during the study period were systematically followed from the intraoperative phase up to six weeks postpartum. Data regarding demographic variables, obstetric characteristics, intraoperative findings, and postoperative complications were collected using a structured proforma. Statistical analysis was performed to identify clinical and procedural risk factors associated with adverse maternal outcomes. Among the study population, 200 cases developed complications, yielding an overall complication rate of 6.21%. The most frequently observed intraoperative complications included haemorrhage and extension of uterine incision, while postoperative complications comprised surgical site infection, puerperal sepsis, urinary tract infection, and thromboembolic events. Significant associations were observed between complication rates and factors such as prolonged labour, multiple per vaginal examinations, anaemia, premature rupture of membranes, and increased duration of surgery. These findings underscore the substantial burden of preventable maternal morbidity associated with caesarean delivery and highlight the importance of early identification and optimization of modifiable risk factors. Targeted perioperative strategies may contribute to improved maternal outcomes and reduced postoperative complications in tertiary care obstetric practice.